Maleya Amani, Kakudji Yves Kalume, Mwazaz Roger Munan, Nsambi Joseph Bulenda, Ngwej Hugues Ilunga, Mukuku Olivier, Kinenkinda Xavier, Luhete Prosper Kakudji
Département de Gynécologie-Obstétrique, Faculté de Médecine, Université de Lubumbashi, République Démocratique du Congo.
Institut Supérieur des Techniques Médicales de Lubumbashi, République Démocratique du Congo.
Pan Afr Med J. 2019 May 29;33:66. doi: 10.11604/pamj.2019.33.66.18528. eCollection 2019.
Unattended pregnancies are characterized by significant morbidity maternal and morbidity and mortality fetal. This study aims to determine the frequency of unattended pregnancies, to describe the socio-demographic profile and to assess the maternal and fetal outcomes during childbirth among women who did not attend antenatal care (ANC) in the city of Lubumbashi.
It was an analytical cross-sectional study of maternal pregnancy from December 2013 to May 2014 in 10 maternity hospitals in Lubumbashi. Women who did not receive ANC were compared to women who had followed them (ANC≥4). Maternal socio-demographic parameters, maternal and perinatal morbidity and mortality were analyzed.
We found that the frequency of no pregnancy monitoring was 21.23% and the mean number of antenatal visits was 2.6 ± 1.9. An analysis of the relationship between ANC and socio-demographic characteristics of women who were delivered shows that the lack of follow-up was 2.29 times higher for adolescent girls than for adult women (OR=2.29 [1.54-3.41]), 4 times higher for women living alone than for women living in unions (OR=4.00 [2.05-7.79]) and 4.08 times higher for women with low levels of education (illiterate or primary) than among those with a high level of education (OR=4.08 [3.08-5.40]). Compared to those who followed them well, we did not find that women who did not attend ANC had a high risk of obstetric emergency (OR = 1.90 [1.26-2.95]), rupture of membranes fetal admission (OR=1.31 [1.02-1.68]), fetal mal presentation (OR=1.89 [1.03-3.44]), caesarean delivery (OR=1.78 [1.21-2.63]), eclampsia (OR=3.00 [1.09-8.70]), uterine rupture (OR=4.76 [1.00-47.19]) and anemia (OR=2.33 [1.06-5.13]). Rates of preterm birth (OR = 1.93 [1.33-2.80]), post-maturity (OR=1.47 [1.00-2.30]), low birth weight (OR=2.33 [1.56-3.46]), neonatal depression (OR=3.89 [2.52-6.02]), neonatal transfer (OR=1.60 [1.11-2.32]) and perinatal mortality (OR=2.70 [1.59-4.57]) were significantly higher in neonates from women with prenatal consultations than in those with well followed.
Our study shows that the lack of follow-up of ANC is associated with high maternal morbidity and high perinatal morbidity and mortality in our environment.
意外妊娠的特点是孕产妇发病率高以及胎儿发病率和死亡率高。本研究旨在确定意外妊娠的发生率，描述社会人口学特征，并评估卢本巴希市未接受产前护理（ANC）的妇女在分娩期间的母婴结局。
这是一项对2013年12月至2014年5月在卢本巴希市10家妇产医院的孕产妇进行的分析性横断面研究。将未接受ANC的妇女与接受过ANC的妇女（ANC≥4次）进行比较。分析了孕产妇的社会人口学参数、孕产妇和围产期发病率及死亡率。
我们发现未进行妊娠监测的发生率为21.23%，产前检查的平均次数为2.6±1.9次。对ANC与分娩妇女的社会人口学特征之间的关系进行分析表明，少女未接受随访的可能性是成年女性的2.29倍（OR=2.29[1.54-3.41]），独居女性是同居女性的4倍（OR=4.00[2.05-7.79]），低教育水平（文盲或小学学历）女性是高教育水平女性的4.08倍（OR=4.08[3.08-5.40]）。与接受良好随访的妇女相比，我们未发现未接受ANC的妇女有产科急诊的高风险（OR = 1.90[1.26-2.95]）、胎膜早破（OR=1.31[1.02-1.68]）、胎位异常（OR=1.89[1.03-3.44]）、剖宫产（OR=1.78[1.21-2.63]）、子痫（OR=3.00[1.09-8.70]）、子宫破裂（OR=4.76[1.00-47.19]）和贫血（OR=2.33[1.06-5.13]）。早产（OR = 1.93[1.33-2.80]）、过期产（OR=1.47[1.00-2.30]）、低出生体重（OR=2.33[1.56-3.46]）、新生儿窒息（OR=3.89[2.52-6.02]）、新生儿转诊（OR=1.60[1.11-2.32]）和围产期死亡率（OR=2.70[1.59-4.57]）在未进行产前检查的妇女所生新生儿中显著高于接受良好随访的妇女所生新生儿。
我们的研究表明，在我们的环境中，ANC随访不足与高孕产妇发病率以及高围产期发病率和死亡率相关。
